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双击自动滚屏 信息来源:世界卫生组织官方网站 发布时间:2009/5/28



Note: Both the Chinese and English versions are from the official web of WHO



What is swine influenza? 什么是甲型H1N1流感?


Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (14%). The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an increased incidence in the autumn and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.



Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.




What are the implications for human health?



Outbreaks and sporadic human infection with swine influenza have been occasionally reported. Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.



Since typical clinical presentation of swine influenza infection in humans resembles seasonal influenza and other acute upper respiratory tract infections, most of the cases have been detected by chance through seasonal influenza surveillance. Mild or asymptomatic cases may have escaped from recognition; therefore the true extent of this disease among humans is unknown.




Where have human cases occurred?



Since the implementation of IHR(2005)1 in 2007, WHO has been notified of swine influenza cases from the United States and Spain.




How do people become infected?



Humans usually contract swine influenza from infected pigs, however, some cases lack contact history with pigs or environments where pigs have been located. Humantohuman transmission has occurred in some instances but was limited to close contacts and closed groups of people.





Which countries have been affected by outbreaks in pigs?



Swine influenza is not notifiable to international animal health authorities (OIE, www.oie.int), therefore its international distribution in animals is not well known. The disease is considered endemic in the United States. Outbreaks in pigs are also known to have occurred in North America, South America, Europe (including the UK, Sweden, and Italy), Africa (Kenya), and in parts of eastern Asia including China and Japan.




What about the pandemic risk?



It is likely that most people, especially those who do not have regular contact with pigs, do not have immunity to swine influenza viruses that can prevent the virus infection. If a swine virus establishes efficient humanto human transmission, it can cause an influenza pandemic. The impact of a pandemic caused by such a virus is difficult to predict: it depends on virulence of the virus, existing immunity among people, cross protection by antibodies acquired from seasonal influenza infection and host factors.




Is there a human vaccine to protect against swine influenza?



There are no vaccines that contain the current swine influenza virus causing illness in humans. It is not known whether current human seasonal influenza vaccines can provide any protection. Influenza viruses change very quickly. It is important to develop a vaccine against the currently circulating virus strain for it to provide maximum protection to the vaccinated people. This is why WHO needs access to as many viruses as possible in order to select the most appropriate candidate vaccine virus.




What medicines are available for treatment?



There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir).



Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines.



Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of treatment. The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.



Information is insufficient to make recommendations on the use of the antivirals in treatment of swine influenza virus infection. Clinicians should make decisions based on the clinical and epidemiological assessment and harms and benefits of the treatment of the patient2. For the ongoing outbreak of the swine influenza infection in the United States and Mexico, national and local authorities are recommending use oseltamivir or zanamivir for treatment of the disease based on the virus’s susceptibility profile.




What should I do if I am in regular contact with pigs?



Even though there is no clear indication that the current human cases with swine influenza infection are related to recent or ongoing influenzalike disease events in pigs, it would be advisable to minimize contact with sick pigs and report such animals to relevant animal health authorities.



Most people are infected through prolonged, close contact with infected pigs. Good hygiene practices are essential in all contact with animals and are especially important during slaughter and postslaughter handling to prevent exposure to disease agents. Sick animals or animals that died from disease should not be undergoing slaughtering procedures. Follow further advice from relevant national authorities.




How can I protect myself from getting swine influenza from infected people?



In the past, human infection with swine influenza was generally mild but is known to have caused severe illness such as pneumonia. For the current outbreaks in the United States and Mexico however, the clinical pictures have been different. None of the confirmed cases in the United States have had the severe form of the disease and the patients recovered from illness without requiring medical care. In Mexico, some patients reportedly had the severe form of the disease.



To protect yourself, practice general preventive measures for influenza:



l          Avoid close contact with people who appear unwell and who have fever and cough.


l          避免与看起来身体不适和有发烧和咳嗽症状的人密切接触。

l          Wash your hands with soap and water frequently and thoroughly.


l          经常和彻底地用肥皂和水清洗双手。

l          Practice good health habits including adequate sleep, eating nutritious food, and keeping physically active.


l          保持良好卫生习惯,包括睡眠充足、营养膳食和坚持锻炼。

If there is an ill person at home:



l          Try to provide the ill person a separate section in the house. If this is not possible, keep the patient at least 1 meter in distance from others.


l          设法在家中为病人单独辟出一块空间。如果这样做不可行,让病人与其它人至少保持一米远的距离。

l          Cover mouth and nose when caring for the ill person. Masks can be bought commercially or made using the readily available materials as long as they are disposed of or cleaned properly.


l          护理病人时掩住口鼻。可从店里购买口罩,或者使用现成材料自己制作,只要可加以适当清洗。

l          Wash your hands with soap and water thoroughly after each contact with the ill person.


l          每次与病人接触之后,彻底用肥皂和水清洗双手。

l          Try to improve the air flow in the area where the ill person stays. Use doors and windows to take advantage of breezes.


l          设法改善病人居所的空气流通状况。利用门窗进来一点微风。

l          Keep the environment clean with readily available household cleaning agents.


l          使用现成的家庭清洗剂保持环境清洁卫生。

If you are living in a country where swine influenza has caused disease in humans, follow additional advice from national and local health authorities.




What should I do if I think I have swine influenza?如果认为自己已患上甲型H1N1流感,应该怎么办?


If you feel unwell, have high fever, cough and/or sore throat:



l          Stay at home and keep away from work, school or crowds as much as possible.


l          尽可能呆在家中,不要上班、上学或去人多的地方。

l          Rest and take plenty of fluids.


l          休息并大量饮水。

l          Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose of the used tissues properly.


l          咳嗽和打喷嚏时用一次性纸巾掩住口鼻,并适当处理用过的纸巾。

l          Wash your hands with soap and water frequently and thoroughly, especially after coughing or sneezing.


l          经常和彻底地用肥皂和水清洗双手,特别是在咳嗽或打喷嚏之后。

l          Inform family and friends about your illness and seek help for household chores that require contact with other people such as shopping.


l          将你的病情告诉家人和朋友,并寻求他人帮助来处理需要与其它人接触的家务活,比如采购东西。

If you need medical attention:



l          Contact your doctor or healthcare provider before travelling to see them and report your symptoms. Explain why you think you have swine influenza (for example, if you have recently travelled to a country where there is a swine influenza outbreak in humans). Follow the advice given to you for care.


l          去看医生或到保健机构看病前先与之进行联系,并报告你目前的症状。说明为什么你认为自己患上甲型H1N1流感(例如,你是否最近去过发生人间猪流感疫情的国家)。遵循医生给你的治疗意见。

l          If it is not possible to contact your healthcare provider in advance, communicate your suspicion of having swine influenza immediately upon arrival at the healthcare facility.


l          如果无法预先与所在地保健机构取得联系,抵达保健机构后立即说明你怀疑自己患有甲型H1N1流感。

l          Take care to cover your nose and mouth during travel.


l          外出期间注意掩盖口鼻。

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